Apparatus for treating back ailments

ABSTRACT

An apparatus for treating back ailments includes patient support table (10) for supporting a patient in a horizontal, lying position; a first tension take-up belt (12) arranged to pass around the pelvis area of a patient; a second tension take-up belt (14) arranged to pass around the chest of a patient; tensioning belts (131, 131&#39;; 132, 132&#39;) arranged for connection to a selected one of the first and the second tension take-up belt (12, 14); carriage (11) which are intended to support the pelvis region or the chest region of the patient, and which can be readily moved relative to the patient support table (10); a movably arranged and vertically adjustable lumbar support (15) mounted on the patient support table; and drives (141, 142, 143, 145) for activating the tensioning belts, and the readily movable carriage. The apparatus is also provided with movement program control unit (18) through which a diagnosis of the patient&#39;s back can be made, treatment carried out in accordance with a set program of movements, and the result of the treatment analyzed.

TECHNICAL FIELD

The present invention relates to apparatus for treating back ailments,and more particularly to an apparatus of the kind which includes patientsupport means for supporting a patient in a horizontal, lying position;a first tension take-up means arranged to pass around the pelvis area ofa patient; a second tension take-up means arranged to pass around thechest of a patient; tensioning means arranged for connection to aselected one of said first and said second tension take-up means;carriage means which are intended to support the pelvis region or thechest region of the patient, and which can be readily moved relative tosaid support means; a movably arranged and vertically adjustable lumbarsupport means mounted on the patient support means; and drive means foractivating the tensioning means, and the readily movable carriage means.

BACKGROUND ART

Various apparatus for treating back ailments are known to the art, theseapparatus being of widely different designs and operational modes.

One such apparatus includes a movable support surface intended tosupport the pelvis region of a patient, said support means beingarranged for rotation about a first horizontal axis, about a secondhorizontal axis, and about a vertical axis; a fixed support surface forsupporting the chest of the patient; and lumbar support means. It is notpossible, however, to apply traction with such an apparatus, which is aserious disadvantage, since traction must be considered an importantpart of a complete program for successfully treating back ailments.Neither are means provided which are capable of regulating the height ofthe lumbar support means during the course of treatment in question, itwould appear that the support means can only be set in an initialposition corresponding to the shape of the back of a patient undergoingtreatment.

Another known apparatus includes a fixed support for supporting thechest area of a patient; lumbar support means which are rotatable abouta vertical axis, so that said lumbar support means can accompanymovement of the patient in the longitudinal direction of the apparatus;and movable pelvis support means, which can be imparted a translatorymovement in the longitudinal direction of the apparatus (and of thepatient). Consequently, it is not possible with this known apparatus toexecute any form of rotary movement, other than small movementsconforming to a pre-arranged program.

A further known apparatus of the aforesaid kind includes two movablesupport means which are arranged one behind the other and which can berotated about one and the same axis but in mutually differentdirections, so as to move in an oscillatory fashion, thereby to turn ortwist the back of the patient of some extent. The apparatus has no meansfor supporting the small of the back, i.e. the lumbar region of thepatient, and cannot subject the patient to traction. Moreover, theturning or twisting (torsion) action is limited to a single axis ofrotation.

These and similar apparatus normally have a very limited healing effecton the back ailments of the patient, and when used wrongly can sometimesbe very dangerous.

Accordingly, it is a first object of this invention to provide anapparatus for treating back ailments which will afford the best possibletreatment with the least possible discomfort to the patient.

Another object is to provide an apparatus of the kind described withwhich a diagnosis can be made, treatment carried out, and the result ofthe treatment analysed, in a manner such that the back ailment of apatient can be charted and treated correctly, optionally through thepatient's own activities, and in all events so that it is establishedwhat should (or can) be done, and so that treatment is effected at thecorrect locations and at suitable moments in time.

DISCLOSURE OF THE INVENTION

In accordance with the invention, these objects are achieved by means ofan apparatus according to the invention which is characterized in thatthe apparatus further includes a movement program control unit which isarranged to initiate and to control a desired sequence of movements inaccordance with a program entered therein, said unit including means forregistering and recording the reactions of and the sensationsexperienced by the patient as said patient executes the movements insaid program, and operator or patient controlled means for halting allmovement of the apparatus, irrespective of the point reached in theprogram.

The control unit preferably includes a movement selector panel and amovement control panel which are coupled to the drive means in a mannersuch that a patient suffering from a back ailment can be systematicallysubjected to an initial diagnosis; that a movement program for thepatient's back can be established on the basis of said diagnosis; andthat the status of the patient's back subsequent to being treated can berecorded and compared with the status of said patient's back prior tocarrying out said treatment.

The diagnosis is conveniently carried out in accordance with apreviously compiled program stored in data processing means incorporatedin the control unit and, following instructions given by the doctor orphysiotherapist, can be carried out by the patient himself/herself, bymanipulation of a control means on the control panel. The programincludes instructions for testing the ability of the patient to move thesmall of his back, to bend sideways, and to turn.

The movement program is suitably compiled by a doctor, and when requiredis initiated through the selector panel in the control unit. Themovement program can be optionally selected automatically in the dataprocessor, by initiating a previously inserted, fixed program, whileobserving the result of the initial diagnosis.

By means of recording means (buttons) arranged in the control panel forindicating or recording sensations of pain during body movement (e.g.traction), the patient is himself able to influence the program, andduring the course of treatment cause factors to be recorded which, whentaken together, present a true picture of the state of the patient'sback. This enables the patient to undergo treatment while in a quiet andrelaxed condition.

So that the invention will be more readily understood and furtherfeatures thereof made apparent, a number of embodiments will now bedescribed with reference to the accompanying schematic drawings, inwhich

FIG. 1 illustrates an apparatus for treating back ailments and having amovement program control in accordance with the invention.

FIG. 2 illustrates the movement program control unit in more detail.

FIG. 3 illustrates an embodiment of a coupling means between the lumbarsupport means and the carriage means; and also illustrates an embodimentof a lumbar support guide means.

FIG. 4 illustrates a first embodiment of a tension control means, andshows the tension take-up means intended for the pelvis region of thepatient.

FIG. 5 is a second embodiment of a tension control means;

FIG. 6 is a third embodiment and FIG. 7 is a fourth embodiment of atension control means.

PREFERRED EMBODIMENTS OF THE INVENTION

The apparatus illustrated in FIG. 1 includes a patient support surface10 for supporting a patient in a horizontal lying position. Arranged forready movement relative to the support surface 10 is a carriage means11, which is intended to support either the pelvis region of the patientor the chest region thereof. As will be made more apparent later on, thecarriage means 11 is arranged for translatory movement and rotational orpivotal movement modes about respective axes, and is driven by drivemeans 141, which may have the form of a motor.

Mounted on the carriage means 11 is a first tension take-up means in theform of a belt 12 which in this embodiment is intended to support thepelvis region of the patient, and which is tensioned by means oftensioning means 131--131', driven by motor 142.

In order to support the chest of a patient during a course of treatment,there is arranged on the support means 10 at some distance from thecarriage means 11, a chest support means 13 which has arranged thereon asecond tension take-up means in the form of a belt 14, which is arrangedto encircle the chest of said patient and which is tensioned by straps132--132', driven by motor 145. In the illustrated embodiment the chestsupport means 13 is stationary relative to the patient support means 10.

Arranged between the pelvis and chest support means 11 and 13 is amovable and vertically adjustable lumbar support means 15. By lumbar ismeant here, and in the following, as well as in the aforegoing, thatarea of the body normally referred to as the "small of the back".

The first tension take-up means, i.e. the belt 12 is placed undertension, e.g. for traction purposes, by means of the tensioning means131 and 131' having the form of cables which extend to a respective post101 and 101' located at one end of the support means 10, and which areoperated by said drive means 142, while the second tension take-up means14, e.g. for holding the chest firmly on the chest support, has the formof tensioning straps 132, 132', which are operated by drive means 145.

The reference 17 identifies a coupling means co-acting between thelumbar support means 15 and the carriage means 11 for a purpose whichwill hereinafter be made apparent.

As will be seen from FIG. 1, each of the drive means 141, 142, 143, 145is connected to a movement program control unit 18, which includes amovement sequence selector panel 19 and a control panel 20, on whichthere is arranged a program control means, in the form of a knob or dial21. Control-signal lines leading to respective drive means 141-145 areshown by chain line 22.

The drive means 141, 142, 143, 145 are designed and operationallyconnected to the control unit 18 in a manner such that when a givensequence of movements is initiated, e.g. translation, through theselector panel 19, and the knob or dial 21 is turned clockwise, thetranslatory movements are carried out successively, while when the knobis turned counter-clockwise, the sequence of movements is effected inthe reverse order.

The knob 21 illustrated in FIG. 1 can be replaced with, for example, alever having three operational states, namely a right-hand state, anintermediate state, and a left-hand state; or with a keyboard having aright-hand button, a left-hand button, and an intermediate button. Allthree embodiments form control means which can be easily reached andmanipulated by the patient. (For the sake of illustration, the controlunit 18 has been drawn slightly to one side of the remainder of theapparatus.)

The control unit 18 illustrated in FIG. 1 includes a data processor (notshown in the Figure) in which is stored a programmed sequence ofmovements which can be initiated through the selector panel 19. Thecontrol panel 20 includes, in addition to the control means 21 (theknob), an alarm button 23, and a recording and/or indicating means (24)for recording sensations of pain experienced during the sequence ofmovements being carried out by the patient (e.g. during traction), saidrecording means being so arranged that when activated by the patient torecord said pain sensations the program is either stopped, or a jump ismade to a further state or part-program thereof.

The selector panel 19 includes a keyboard 200-201 for the selection ofsuch movements as translation, rotation and turning or pivoting of thereadily movable carriage means 11, and for setting the limits to whichsaid movements shall be made; and for setting the vertical translatorymovement of the lumbar support means 15 and for setting the limits towhich such movement shall be made. An array of lamps 202-203 is arrangedto indicate the positions and values (202) in question, and momentarysymbolic images (203) of the sequence of movements being carried out.

The unit 202 includes digital instruments for reading-off the pressureexerted on the lumbar support means 15 (in Newtons, three figures); theheight of said lumbar support means 15 (in centimeters, two figures),the turning or pivot angle (in degrees, two figures), rotation (indegrees, two figures), traction force (in Newtons, three figures), andtime (in minutes, three figures). The unit 203 includes lamps havingsymbols which identify the function in question and which illuminatewhen a corresponding button on the keyboard 200 is pressed.

The control unit 18 can be swung to any position desired by the patientor the physiotherapist.

The control unit 18 also includes a register 25 which is arranged to beactivated at regular intervals, when the patient activates the recordingmeans 24, and at the end of each movement sequence, e.g. translation,for registration of relevant factors, such as, for example, the tensionforce in the tensioning means 131--131', the pressure exerted againstsaid lumbar support means 15, etc.

The data processor incorporated in the control unit 18 is arranged tomake a comparison between the factors registered by the register 25 andderiving from an initial mobility diagnosis--made at the beginning of acourse of treatment--with factors deriving from a movement programcarried out at the end of said course of treatment, thereby enabling aclear and concise picture of the result of said treatment to beobtained.

In the aforegoing it has been assumed that the pelvis support means 11is movable and the chest support means 13 is stationary, and that thetension forces required for traction are generated by the tensioningmeans 131--131', while the tensioning means 132--132' are intended forholding the patient's chest firmly to the chest support means. Ifconsidered suitable, the pelvis support means 11 can bd stationary andthe chest support means 13 movable, wherewith the tension force requiredfor traction is obtained through the take-up means 14. In this respectthe tensioning means 132--132' is suitably modified to coincide, forexample, with the illustrated tensioning means 131--131'. Cables 231-234required for transferring data to and from the various units are locatedbetween the selector panel 19, the control panel 20, and the register25. Data relating to activation by the patient of knob 21, the recordingmeans 24, and the alarm button 23 is transmitted from the control panel20 to the selector panel 19 (with data processor) over cable 231.

Signals containing data relating to instructions for the patient aretransmitted from the selector panel 19 to the control unit 20 over cable232. These instructions are presented on a display 214, and may instructthe patient either to turn the knob 21 or to wait (rest), or may informhim that the course of treatment has been concluded.

Control signals relating to the registration of such data astime-recording, recording of angular values when turning and rotatingrespective support means, recording of tension and pressure values etc.,are transmitted from the selector panel 19 to the register 25 over cable233.

Signals containing data relating to activation by the patient of theknob, the recording means 24 and the alarm button 23 are transmittedfrom the control panel 20 to the register 25 over cable 234.

In principle, the aforedescribed apparatus has three different modes ofuse, namely manual use; use in accordance with an individual program; oruse in accordance with a standard program.

When used manually, a given function, e.g. traction, is selected throughthe keyboard 200. The maximum tension force is set by means of keyboard201, and the value selected is shown on the array-lamps 201. Thefunction selected is initiated by turning the knob 21; this being doneby either the patient or the physiotherapist. When the knob is turned tothe right, the tensioning force is produced through the tensioning means131--131', while the tension in the tensioning means is relaxed whenturning the knob to the left.

When the apparatus is used in conjunction with an individual program,there is first made an initial diagnosis, to establish an original pointof departure with respect to the course of treatment adopted, i.e. thepatient carries out in said apparatus a program entailing movement ofthe small of the back, rotational movements and turning movements, toestablish the degree of mobility of the patient. The doctor orphysiotherapist then compiles a program of treatment, which is enteredinto the memory of the data processor of the control unit, through theselector panel 19. This program is stored, and initiated when thepatient reports for treatment. The patient can carry out the treatmenthimself, by means of the knob 21. When the knob is turned to the right,the program is wound forwards, and is wound backwards when the knob isturned to the left.

As beforementioned, as the program progresses, the patient obtainsthrough the display 214 such instructions as "turn the knob" or "wait".The patient signals the feeling of pain by pressing the knob 24.

When using the apparatus in conjunction with a standard program, thereis used a part-program which has been previously inserted into the dataprocessor and which can be initiated through the selector panel 19. Thedata processor may also be programmed to select the requisitepart-program itself, on the basis of the diagnosis carried out.

By way of summary, a course of treatment can have the following pattern:

1. The patient himself/herself records factors relating to his/her backailment on a form intended therefor.

2. The doctor or physiotherapist investigates the ability of the patientto bend and turn.

3. A statistical diagnosis is made in the apparatus, during which theheight of the small of the back is measured, together with the abilityof the patient to turn or bend sideways (right and left) and to turn intwo directions.

4. A suitable program of treatment is compiled.

5. The patient "runs" through the program himself/herself, whereupondata of interest is registered automatically.

6. A fresh statistical diagnosis is carried out on the apparatus andcompared with the initial diagnosis.

7. A written record of the result of the comparison is obtained from theregister 25, together with suggestions for further treatment.

The first mentioned comparison made in the data processor between theinitial mobility diagnosis and the concluded program can also includefactors of particular interest recorded from the actual treatmentcarried out such as the maximum extent to which the patient is able tobend, turn etc. without undue discomfort.

In order to ensure that the position of the lumbar support means 15conforms more readily to the positions of other apparatus components, sothat the patient suffers no side effects, the lumbar support means 15according to one embodiment of the invention is so arranged that whenthe carriage means 11 moves in accordance with a pre-arranged program,movement of the lumbar support means 15 is adapted in a manner which isdetermined by and which conforms to the natural position of the small ofthe back of said patient, i.e. the lumbar region thereof. This iseffected, inter alia, by means of a mechanical coupling 17, 26-28between the lumbar support means 15 and the carriage means 11 and by thedesign of said lumbar support means 15, such that when the carriagemeans 11 executes a horizontal translatory or turning movement, thelumbar support means 15 will adopt the position determined by andconforming to the natural attitude of the small of the back of saidpatient during respective movements, while when the carriage means 11executes a rotary movement about a horizontal axis, the lumbar supportmeans 15 will take the same position as the chest support means 13during the whole of said rotary movement.

In accordance with this embodiment, in those cases when the carriagemeans 11 forms the pelvis support means, the lumbar support means 15will accompany the translatory and turning movements of the pelvissupport to a greater or lesser extent, but will remain stationary duringthe rotary movement thereof. On the other hand, when the carriage means11 forms the means 13 for supporting the chest region of the patient,the lumbar support means 15 will accompany the carriage means/chestsupport means throughout the whole of its rotary movement.

As will be seen more clearly from FIG. 3, said mechanical coupling 17(FIG. 1) is a combined slide and pivot coupling and comprises a rod 26which is freely slidable at one end thereof in the longitudinaldirection of the apparatus in a bush 27 which is fixed to the carriagemeans 11. The other end of the rod 26 is mounted for free pivotalmovement in a bracket structure 28 attached to the lumbar support means15.

The lumbar support means 15 of the FIG. 3 embodiment is arranged onrollers or castors 40, so as to be freely movable relative to thepatient support means 10. As beforementioned, the height of the lumbarsupport means 15 above the patient support means 10 is adjustable.

The arrows A-A indicate the turning or pivoting movements executed bythe carriage means 11 about a vertical axis, and the arrows B-B indicatethe rotary movements of said carriage means about a horizontal axis. Asa result of the extension of the lumbar support means 15 in thetransverse direction of the apparatus, i.e. the distance between therollers 40 in the transverse direction, said rollers will act as amechanical guide means to positively prevent the lumbar support meansfrom accompanying the rotary movement of the carriage means 11 aboutsaid horizontal axis. The ability of the rod 26 to slide freely relativeto the bush 27 is also contributory in this respect. Another method ofmechanically guiding the lumbar support means for the aforesaid end, isto arrange a rectangular recess slightly beneath the uppermost surfaceof the support, and to insert in said recess a guide means which isfixed relative to the patient support means 10 and which permits freedomof movement in the horizontal plane, within required limits, but whichopposes any tendency of the lumbar support means to rotate about ahorizontal axis.

In the foregoing it has been assumed that it is the pelvis support meanswhich forms the carriage means 11. Although this is considered to be themost practical, there is nothing to prevent the pelvis support meansfrom being permanently fixed, and allowing the chest support means toform said movable carriage means, as beforementioned. In this lattercase, however, the mechanical guide must be such as to enable the lumbarsupport means 15 to accompany the rotary movement of the carriage means11, for example by providing the support and said carriage means with acommon supporting surface, while being guided by the couplings 27-26-28.

Thus, when the patient is under traction, the lumbar support means 15,through the rod and bush coupling 26 and 27, will take a positionconforming to the natural position of the patient's lumbar region, asthe carriage moves relative to the patient support means 10. On theother hand, when the carriage means is pivoted or swung about ahorizontal axis, the lumbar support means will accompany said pivotalmovement through the agency of the rod and link bracket coupling 26 and28 and the rollers 40, to an extent determined by, and conforming to thenatural position of the patient's lumbar region, As beforementioned, therollers 40 form a positive guide means which when the carriage means 11executes a rotational movement about a horizontal axis, cause the lumbarsupport means to take the same position relative to the chest supportmeans 14, during the whole of said rotational movement. All threeconditions placed on the lumbar support through the coupling 26-28 andthe guide means 40 ensure that the lumbar support means will always takea position which conforms to the natural position of the small of thepatient's back.

FIGS. 4, 5 and 6 illustrate alternative embodiments of tension controlmeans, by which the patient can be held firmly to the pelvis supportmeans and to the chest support means, without placing undue strain onthe patient's back.

In the embodiment illustrated in FIG. 4, the belt of the first tensiontake-up means 12 has mounted thereon a first pair of pulleys 112, 112',while the movable carriage means 11 has mounted thereon a second pair ofpulleys 123, 123'. A third pair of pulleys 133, 133' is mounted on thepatient support means 10. The pulley pair 123, 123' is mounted on theunderside of the movable carriage 11, approximately immediately beneaththe pulley pair 112, 112', while the pulley pair 133, 133' is mounted atone end of the patient support means 10, adjacent the post pair101,101'.

The belt is connected to the belt tensioning means 30 via a linearrangement, which in the illustrated embodiment comprises line portions111, 111' extending from said belt to a respective post 101 and 101'.

Each of the line portions 111, 111' connects one of said first pulleys,e.g. 112, with one of the second pulleys 123 and one of said thirdpulleys 133. One end of each line portion is secured to a tensioningmeans 30, while the remaining end of one of said line portions issecured to the patient support means, namely to the post 101 for theline 111 (Correspondingly, the line portion 111' connects the wheel orroller 112' with the pulley 123' and the pulley 133', and one end of theline portion is secured to the tensioning means 30 and the remaining endto the post 101'.) The tensioning means 30 has a grooved wheel 300around which said remaining ends, the co-linking ends, of the lineportions 111, 111' are passed. When the tensioning means 30 is subjectedto a tension force, the forces acting in the lines will be equalizedthrough the action of the wheel 300, while possibly turning the carriagemeans 11 at the same time.

FIG. 5 illustrates a modification of the embodiment illustrated in FIG.4, in which the force-equalizing wheel 300 has been omitted from thetensioning means 30. Thus, the lower ends of the line portions 111, 111'are secured directly to the tensioning means 30, which means that eachline has a constant length during the course of the treatment.Consequently, the tension forces in the two lines may be mutuallydifferent and may vary during the course of said treatment.

A further embodiment is illustrated in FIG. 6. In addition to theapparatus components described in the aforegoing, the embodimentaccording to FIG. 6 includes a fourth pair of pulleys 102, 102', whichare mounted on the posts 101, 101'. Attached to the sides of the beltbelonging to the tension take-up means 12 are rigid plates 113, 113'.These plates extend over the whole width of the belt and somewhat beyondthe edge of the belt facing the foot-end of the support means (furthestaway from the reader). One end of the line portion 111 is attached tothe plate 113 and extends around the pulleys 102, 112, 123 and 133 inthe order just mentioned, while one end of the line portion 111' isattached to the plate 113' and extends around the pulleys 102', 112',123' and 133' in that order. The remaining ends of the line portionsmeet around the grooved wheel 300 in the tensioning means. Thus, twoparts of the line 111 and 111' pass between a respective plate 113 and113' and a respective pulley 102 and 102', which has been foundimportant with respect to the application of the tensioning force.

In the aforegoing it has been assumed that it is the pelvis region ofthe patient which is to be pulled, while the chest region is firmlyanchored to the support means. In principle the reverse may be the case,so that it is the chest region which is pulled. This reversal, however,necessitates modification of the illustrated arrangements, althoughwhile retaining the principles thereof.

The members 102, 102', 112, 112', 123, 123' and 133, 133' have beenshown and described as pulleys, although, as will be understood, theremembers may have the form of equivalents devices, such as rollers, eyes,etc. which ensure that the lines run freely. The members 111, 111' mayalso comprise straps, bands or the like.

The embodiment according to FIG. 6 can be modified by omitting the wheel300, in which case each of the line portions 111, 111' has the end inquestion securely connected to the tensioning means 30, i.e. in themanner indicated in FIG. 5.

FIG. 7 illustrates a simplified version of the tension control meansaccording to the invention. In this embodiment belt 12 (or the belt 14)is provided with a first pair of pulleys 112,112', while a second pairof pulleys is mounted on the movable carriage means 11. A linearrangement comprises line portions 111,111' and connects respectivepulleys of the first pair to respective pulleys of the second pair. Oneend of the line arrangement is conncected to the tensioning means 30 or141, while the other end is fixedly arranged relative to patient supportmeans 10, the first or second straps 12,14, or to the line itself.

I claim:
 1. An apparatus for treating back ailments, and moreparticularly an apparatus of the kind which includes patient supportmeans (10) for supporting a patient in a horizontal, lying position; afirst tension take-up means (12) arranged to pass around the pelvis areaof a patient; a second tension take-up means (14) arranged to passaround the chest of a patient; tensioning means (131, 131'; 132, 132';111, 111'; 30) arranged for connection to a selected one of said firstand said second tension take-up means (12,14); carriage means (11)intended to support the pelvis region or the chest region of thepatient, and which can be readily moved relative to said patient supportmeans (10), a movably arranged and vertically adjustable lumbar supportmeans (15) mounted on said patient support means (10); and drive means(141,142,143,145) for activating said tensioning means and the readilymovable carriage means according to selected program instructions,characterized in that the apparatus includes a movement program controlunit (18) arranged to control said drive means (141,142,143, 145) toinitiate and to control a selected sequence of movements in accordancewith a program entered therein, said control unit (18) including: amovement sequence selector panel (19) having means (200-201) forselecting translatory, rotational and pivotal movement of the carriagemeans (11), for setting the limits of such movements, and forrestricting the vertical movement of the lumbar support means (15); acontrol panel (20) which is coupled to the selector panel (19) and whichhas arranged thereon a control means (21) for controlling the sequenceof movements selected through said selector panel (19), said controlmeans (21) having three functional states, a first state of whichadvances the program, a second state of which reverses the program and athird state of which halts the execution of said program.
 2. Anapparatus according to claim 2, characterized in that the control unit(18) has incorporated therein a data processor which is arranged to beinitiated through the selector panel (19); and in which incorporated inthe control panel (20) is a recording means (24) which is intended torecord sensations of pain experienced during a sequence of movementsbeing performed, and which is arranged to influence the program uponrecording such sensations.
 3. An apparatus according to claim 2,characterized in that incorporated in the control unit (18) is aregister (25) which is arranged to be activated upon activation of therecording means (24), and at the end of each sequence of movements, in amanner to register pertinent factors, such as the position of thereadily movable carriage means (11), and the lumbar support means (15),the tension in the tensioning means (131,131'; 132,132'; 111,111'; 30),and the pressure exerted on the lumbar support means (15).
 4. Anapparatus according to claim 3, characterized in that the data processoris arranged to make a comparison between factors obtained from aninitial diagnosis and registered by the register (25) and factors of aprogram of movements carried out at the end of a treatment period.
 5. Anapparatus according to any one of claims 1-4, characterized in that themovable and vertically adjustable lumbar support means (15) is coupledto the readily movable carriage means (11) by means of a mechanicalcoupling (17; 26-28) which is effective in causing the lumbar supportmeans (15) to take a position which conforms to the natural position ofthe patient's lumbar region when the carriage means (11) is made toexecute a translatory or horizontal pivotal movement.
 6. An apparatusaccording to claim 5, characterized in that the mechanical couplingincludes a bush (27) which is fixedly connected to the carriage means(11); a rod (26) which is mounted on the lumbar support means (15) andwhich has one end thereof slidingly received in said bush and a pivotbracket (28) mounted on the lumbar support means (15) and arranged toco-act with the other end of said rod (26).
 7. An apparatus according toclaim 6, characterized in that the apparatus further includes guidemeans (40) for causing the lumbar support means (15) to maintain itsposition relative to the support of the chest region of the patient,when said carriage means executes a rotational movement.
 8. An apparatusaccording to claim 7, characterized in that said guide means (40)comprises rollers, casters or like devices mounted on the undersurfaceof said lumbar support means (15) and arranged to run on the patientsupport means (10).
 9. An apparatus according to any one of claims 1-4,in which the first and second tension take-up means (12,14) have theform of belts, characterized in that the tension control means includesa first pair of pulleys (112,112') mounted on at least one of said firstand second tension take-up means; a second pair of pulleys (123,123')mounted on the movable carriage means (11), and a line arrangementhaving at least one line (111, 111') and connecting each of the pullies(112, 112') of said first pulley pair to a respective pulley (123, 123')of said second pulley pair, said at least one line having an end thereofconnected to the tensioning means (30) and the other end fixedlyarranged relative to either the patient support means (10) or the firstor the second tension take-up means (12,14), or to the line itself. 10.An apparatus according to claim 9, characterized in that the patientsupport means includes a foot-end, the first pair of pulleys (112, 112')is mounted on a rigid plate (113, 113') which is affixed to said belt(12) and which extends across the whole width of said belt and protrudessomewhat beyond that edge of the belt which faces the foot-end of saidpatient support means (10).
 11. An apparatus according to claim 10,characterized in that at least one line (111,111') has one end partpassed around a guide pulley (300) arranged on the tensioning means (30)and the other end of which is secured to a post means (101,101') fixedlymounted to the patient support surface a short distance from the firsttension take-up means (12) in a direction towards the foot-end of thepatient support means (10).
 12. An apparatus according to claim 10,characterized in that one end of said at least one line (111,111') issecured directly to the tensioning means (30), and the other end of theline is secured to a post means (101,101') fixedly mounted on thepatient support means (10) a short distance from tension take-up means(12) in a direction towards the foot-end of the patient support means(10).
 13. An apparatus according to claim 10, characterized in that oneend of said at least one line (111,111') is secured to the tensioningmeans (30) in that the remaining end of said at least one line(111,111') is secured directly to said plate (113,113') and is passedaround a further pulley (102,102') mounted on a post means (101,101')fixedly mounted on the patient support means (10), at a short distancefrom the first tension take-up means (12) in a direction towards thefoot-end of said patient support means (10), and is further passedaround a pulley in said first pulley pair (112,112'), around a pulley insaid second pulley pair (123,123') arranged on the carriage means (11)in the proximity of said post means (101, 101').
 14. An apparatusaccording to claim 13, characterized in that one end of said at leastone line (111,111') is passed around a guide pulley (300) on thetensioning means (30) and is movably secured thereto.
 15. An apparatusaccording to claim 13, characterized in that one end of said at leastone line (111,111') is rigidly secured to said tensioning means (30).